F07.81: Postconcussional syndrome
F07.81 is a billable, specific ICD-10-CM code for postconcussional syndrome. It is valid for submission on a claim.
Check F07.81 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Use additional code
Add a secondary code to capture the detail described below.
- code to identify associated post-traumatic headache, if applicable (G44.3-)
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable, sequela of concussion (S06.0X- with seventh character S)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Postcontusional syndrome (encephalopathy)
- Post-traumatic brain syndrome, nonpsychotic
Other codes that can never be billed with F07.81
Their own Excludes1 notes name this code, so the conflict is not listed above.
- F07.0Personality change due to known physiological condition
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
F07.81 is named in 13 Medicare coverage policies: 12 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56551Billing and Coding: Visual Fields Testing
- A56612Billing and Coding: CT of the Head
- A56799Billing and Coding: Visual Fields Testing
Alphabetic index entries that lead here
- Encephalosis, posttraumatic
- Post-traumatic brain syndrome, nonpsychotic
- Postconcussional syndrome
- Postcontusional syndrome
- Punch drunk
- Concussion›syndrome
- Disorder›postconcussional
- Encephalopathy›postcontusional
- Encephalopathy›traumatic(postconcussional)
- Psychopathy, psychopathic›constitution, post-traumatic
- Status›postcommotio cerebri
- Syndrome›concussion
Code history
Unchanged in every release from FY2024 to FY2027.